EP1508311B1 - Fixing member for an implant and implant composite - Google Patents

Fixing member for an implant and implant composite Download PDF

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Publication number
EP1508311B1
EP1508311B1 EP04019612A EP04019612A EP1508311B1 EP 1508311 B1 EP1508311 B1 EP 1508311B1 EP 04019612 A EP04019612 A EP 04019612A EP 04019612 A EP04019612 A EP 04019612A EP 1508311 B1 EP1508311 B1 EP 1508311B1
Authority
EP
European Patent Office
Prior art keywords
implant
fixing member
bone
tube
pillar
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Lifetime
Application number
EP04019612A
Other languages
German (de)
English (en)
French (fr)
Other versions
EP1508311A3 (en
EP1508311A2 (en
Inventor
Yasumasa Akagawa
Takayasu Kubo
Kazuya Doi
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
AKAGAWA, YASUMASA
Coorstek KK
MMT Co Ltd
Original Assignee
Covalent Materials Corp
MMT Co Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Covalent Materials Corp, MMT Co Ltd filed Critical Covalent Materials Corp
Publication of EP1508311A2 publication Critical patent/EP1508311A2/en
Publication of EP1508311A3 publication Critical patent/EP1508311A3/en
Application granted granted Critical
Publication of EP1508311B1 publication Critical patent/EP1508311B1/en
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0012—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools characterised by the material or composition, e.g. ceramics, surface layer, metal alloy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C8/00—Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0003—Not used, see subgroups
    • A61C8/0004—Consolidating natural teeth
    • A61C8/0006—Periodontal tissue or bone regeneration
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00—Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/02—Inorganic materials
    • A61L27/10—Ceramics or glasses

Definitions

  • the present invention relates to a member for fixing an implant.
  • an implant treatment has been developed as a new dental treatment method in recent years and attracts attention.
  • the implant treatment inserts a metal as an artificial tooth root into the alveolar bone or the gnathic bone and then, places an artificial tooth being similar with natural tooth over the metal making it as the foundation.
  • the implant tooth In comparison with the artificial denture, the implant tooth is superior in stability, and has enough biting force. Further, being different from the bridge, it is unnecessary for the implant tooth to give loads to other teeth or to whittle the adjacent healthy teeth in order to support itself, and it has advantages with no unnatural appearance and with capability of biting like the human's own tooth.
  • the alveolar bone is an organ that depends upon tooth. Namely, the alveolar bone does not exist in a site without tooth, and does not form in the case where there is no tooth by nature. Moreover, without caring after exodontia makes the alveolar bone insensible against stimulation, absorbed and thinner.
  • the alveolar bone and the gnathic bone may be absorbed in circumferential textures or may be damaged.
  • a manipulation of increasing the thickness of an alveolar bone by means of a method referred to as a socket lift or a sinus lift in order to enable to insert a implant in the case where a palatine alveolar bone thinned.
  • the hydroxyapatite is a kind of calcium phosphate represented by a chemical formula [Ca 10 (PO 4 ) 6 (OH) 2 ] and is an main composition composing bone, having adaptability with an own bone, etc., and further having properties of fixing into an organ in vivo by absorption after the lapse of time.
  • the hydroxyapatite ceramics is widely employed as a suitable material for the artificial bone conventionally from the viewpoints of superior strength characteristic, advantage in the harmlessness to a living body.
  • U.S. Patent No. 6,340,648 B1 discloses that a porous sintered body of ceramics which comprises spherical pores communicating with one another substantially throughout the body with relatively high porosity is preferable, among the hydroxyapatite ceramics, because osteoblast and related cells are easy to intrude into most of the pores and as a result, nutrients are supplied sufficiently to the cells.
  • Japanese Patent Application Laid-Open No. 6(1994)-197947 proposes an implant, etc., formed by applying a ceramics coating of a crystallized glass mainly consisting of Diopside over the surface of a metallic substrate.
  • the proposed implant is highly evaluated in its affinity with a living body and its mechanical strength.
  • Japanese Patent Application Laid-Open No. 2001-245903 proposes gnathic bone prosthesis materials having tooth root with simple structure, easily treatable, and giving capability of not only prosthesis of bone but also regeneration of tooth easily.
  • the implant is inserted directly in the own bone in order to support the implant stably and to obtain a good biocompatibility. Therefore, regarding with an implant insertion site, a practical patient-friendly technology for forming an alveolar bone or a gnathic bone sufficiently in the amount and the condition for strengthening the bone tissue was eagerly demanded.
  • US 5,716,359 refers to an anchoring element used for driving and fixing a screw, bolt or other part into a bone.
  • US 4,629,464 A1 refers to a sintered microporous hydroxyapatite material having a core-and-crust structure of which the matrix of the core portion and the crust layer having a thickness of 0.1 to 2 mm are formed of microporous material, the core portion being formed of the matrix and pores of 0.1 to 2 mm diameter distribution throughout the matrix.
  • the present invention is aimed for overcoming the foregoing technical problems. This object is achieved with a fixing member according to claim 1.
  • the present invention as defined in claim 1. provides a fixing member
  • Mesenchymal stem cells, bone marrow cells or osteoblast cells are preferable to be introduced into the tube or the pillar consisting essentially of the hydroxyapatite ceramics. Because the porous article of hydroxyapatite ceramics allows a lot of cells to intrude into it, introducing cells with capability of promoting the generation of bone around the implant insertion site forms bone swiftly, increases the strength of the bone, and also promotes synostosis between the implant and its fixing member.
  • Platelet Rich Plasma is preferable to be introduced into the tube or the pillar consisting of a hydroxyapatite ceramics in order to promote breeding of bone cells and curing of gingiva.
  • PDGF Platelet Derived Growth Factor
  • FGF Fibroblast Growth Factor
  • TGF- ⁇ Transforming Growth Factor-beta
  • HGF Hepatocyte Growth Factor
  • BMP Bone Morphogenetic Protein
  • VEGF Vascular Endothelial Growth Factor
  • EMDOGAIN® Enamel Matrix Derivative
  • a cross-sectional area perpendicular to the axial direction of the fixing member for the implant is from 1.5 times to 50 times as large as a cross-sectional area perpendicular to the axial direction of the implant.
  • the present invention provides an implant composite which comprises an implant inserted inside of the tube or into the pillar of the above fixing member for the implant.
  • the ceramics porous article may further comprises other calcium phosphate based ceramics such as tricalcium phosphate (TCP), etc. Further, it usually takes at least one week and up to about twelve months to augment patients' own bone tissue. Hydroxyapatite is main composition of bone, comparatively superior in mechanical strength and so on, and is a material that is suitably superior in biocompatibility. Moreover, it also has features that a lapse of several years makes it being absorbed by degrees into living tissue and that it may favorably replace with living bone.
  • TCP tricalcium phosphate
  • a hydroxyl group or a phosphate group of the hydroxyapatite may be partially substituted with a carbonic acid group.
  • the porous article consisting of the hydroxyapatite ceramics preferably has pore structures in which a number of approximately spherical pores mutually contact communicating three-dimensionally opening at the contact area and has an averaged porosity of at least 65 %.
  • the foregoing pore structure allows cells, blood and so on each forming bone to intrude into inside of the ceramics porous article from the entire direction and enables to promote regeneration of the bone as a whole.
  • FIG. 1 is a schematic perspective view illustrating one embodiment of the fixing member for the implant in accordance with the present invention.
  • a tube 1 consisting of hydroxyapatite ceramics composes the fixing member for the implant and an inside 1a of the tube makes a cavity.
  • At least one part, preferably all, of the tube 1 is a ceramics porous article consisting of a hydroxyapatite formed by agitation foaming (or stirring), in which a number of approximately spherical pores mutually contact having pore structures communicated three-dimensionally opened at the contact area and having an averaged porosity of from 65 % to 85 %.
  • the usage of the above-described ceramics porous article as the fixing member for the implant promotes regeneration of bone even at the implant insertion site being void because cells intrude within the pores in a short time, and bone tissue consisting of 100 % own bone will regenerate between the fixing member for an implant and the implant. Accordingly, bone tissue consisting only of own bone regenerates with good condition at the implant insertion site. Therefore, both the implant consisting of titanium alloy, etc., and the bone tissue can be integrated rigidly and the mechanical strength of the portion should be so increased early as to stably support the implant inserted inside the tube 1.
  • the averaged porosity of the porous article is at least 65 % and up to 85 %.
  • the averaged porosity is less than 65 %, it becomes difficult that the cells intrude and adhere within the fixing member for the implant. Moreover, a circulation of blood, etc., also becomes difficult.
  • the fixing member when the averaged porosity exceeds 85 %, the fixing member lacks in mechanical strength and tends to break down.
  • the tube or the pillar may be preferable to be a right circular tube or a right circular pillar; however, the profile circle is not limited to exactly circular but may be elliptical, etc. Furthermore, the tube may have a bottom. Moreover, plural of the circular tube or the circular pillar may be arranged in a raw to provide a structure enabling to introduce plural of implant tooth.
  • the tube may be formed in a manner that the porosity increase or decrease inclining towards vertical direction taking workability and mechanical strength of the tube into consideration. Inclination of the porosity may be formed by employing a laminate structure.
  • the porosity may be settled to increase or decrease continuously or in stepwise towards the growing direction of the teeth from maxillary bone or mandible bone.
  • porous article in the present invention may be used as an implant composite optionally in combination with an article consisting of compact material of hydroxyapatite ceramics in a standpoint of reinforcement.
  • a structure consisting of the compact article as the inner part and the porous article as the outer circumferential part enables to support the implant tooth strongly in the inside and promotes bone generation in the outer circumferential part.
  • the compact article capable of supporting the implant is defined as having a porosity of up to 10 %.
  • the porosity is preferably up to 5 % and desirable to be zero.
  • the averaged pore diameter of the porous article is at least 150 ⁇ m and up to 600 ⁇ m. Furthermore, it is preferable that the averaged opening diameter at the communicating area of each pores of the porous article is at least 30 ⁇ m.
  • the averaged pore diameter and the averaged opening diameter as the foregoing description will improve easiness in intrusion of the cells into the implant, and accelerate the intruding rate or breeding rate thereby promoting the regeneration of bone as a whole.
  • the porous article of hydroxyapatite ceramics thus described is formed by agitation foaming slurry containing the hydroxyapatite.
  • the agitation foaming enables to easily control the foregoing high porosity, increasing porosity or decreasing porosity, pore properties, etc., which are suitable as a fixing member for the implant; and further enables to obtain the porous article with relatively high mechanical strength.
  • the agitation foaming further enables to form a compact skeleton (the remaining portion except pores) of the porous article of the hydroxyapatite ceramics with the porosity of 5 % or smaller. Furthermore, it induces to form own bone among the pores of the fixing member for the implant and accordingly enables to use the inserted implant semi permanently without decaying the alveolar bone or the gnathic bone adjacent the treated portion again after the treatment.
  • the porosity of the skeleton is preferably 3 % or smaller.
  • hydroxyapatite powder and cross-linking resin such as polyethyleneimine, and so on are added into a solution of dispersing agent; and then, by agitating and mixing the solution, ingredient slurry is prepared. Subsequently, polyoxyethylene lauryl ether as a foaming agent is added thereto and the resultant slurry is foamed up by mechanical stirring to make the foam uniform and stable resulting in foamed slurry.
  • a cross-linking agent such as sorbitolpolyglycidyl ether is added into the foamed slurry; and then, by agitating and mixing the resultant slurry, porous slurry is prepared. Still further, the porous slurry is introduced into a die, molded and formed to porous gelatinization article (cross-linking article) in the situation maintaining the foamed structure; thereafter sintering it, a ceramics porous article is obtained.
  • the height is about 1 to 25 mm
  • the outside diameter is preferably about 2 to 15 mm corresponding to a diameter of the tooth, each depending on the size of the implant tooth or the situation of the patient's bone.
  • the inside diameter of the tube is about 1 to 10 mm.
  • various factors such as cells for promoting generation of bone, bone formation factor, angiogenesis factor and so on are soaked into the surface of the fixing member for the implant of the present invention with the purpose of promoting generation of bone.
  • the pillar made of the hydroxyapatite ceramics is disposed in a manner that the peripheral surface of the pillar is surrounded at least 70 % by the tube.
  • the pillar is made of ceramics porous articles consisting of a hydroxyapatite formed by agitation foaming, in which a number of approximately spherical pores mutually contact having pore structures communicated three-dimensionally opened at the contact area, and wherein the averaged porosity of the pillar is greater than the averaged porosity of the tube.
  • the averaged porosity of the pillar is preferably at least 80 %, and more preferably at least 85 %. Further, it may be suitable that no distinct border exists between the tube and the pillar, and that the porosity gradually changes between them.
  • the implant tooth should be inserted into the pillar, filling the pillar part with the foregoing ceramics porous article of the hydroxyapatite rather than leaving it void situation easily maintains the bone cells and enables to extremely promote regeneration of bone.
  • the hole with a circular section is easy to be drilled; accordingly, the circular section is suitable for the fixing member for the implant.
  • a membrane method is jointly carried out in order to prevent immersion of epidermic cells and to efficiently regenerate own bone. The membrane method is carried out by applying a membrane with or without absorbency, or by coating a bone wax respectively over the area being in contact with mucosa.
  • the size of the fixing member for the implant will be adjusted appropriately depending on the amount and the condition of the alveolar bone or the gnathic bone at the inserting part of the implant tooth, it is usually about 10 mm in height, and might be entirely inserted into the alveolar bone or the gnathic bone. Further, it is preferable that a layer of the porous article of hydroxyapatite ceramics with the thickness of 1 mm or greater should exist uniformity around the implant in order to sufficiently form the reinforced bone adjacent the implant. Furthermore, it is preferable that the fixing member for the implant might be chamfered off and rounded the corner in order to prevent injuring the gingiva or the mucosa.
  • small slits or linear holes may be optionally provided over the outer circumferential area of the tube as the fixing member for the implant. These will make the bone cells easily intrude into the tube and will enable to promote bone formation.
  • FIG. 2 shows an implant composite in which an implant 2 is preparedly inserted inside a tube 1 as the fixing member for the implant.
  • the implant composite shown in FIG. 2 illustrates an integration of an implant with a fixing member for the implant preparedly before the implant is inserted into a bone.
  • the implant composite enables to save an operation in oral cavity. Besides, the usage of the fixing member for the implant in accordance with the present invention simplifies, reduces and summarizes the medical treatment because it regenerates own bone that can support the implant stably.
  • the implant is made of titanium or titanium alloy. Titanium is a metal superior in biocompatibility and mechanical strength, and because the bone cells are easy to fix with the titanium, the implant made of titanium is capable of fixing inside of the tube as the fixing member for the implant.
  • the area where the implant is fixed to is only made of bone cells rather than the condition where the hydroxyapatite ceramics and the bone cells mixed each other.
  • a layer of own bone is formed among a space made between an outer circumferential area of the implant and the hydroxyapatite ceramics composing the fixing member for the implant.
  • a structure of promoting a formation of own bone may be employable wherein the upper part and the lower part of the implant tooth is in contact with the fixing member for the implant, supporting and fixing them tight by means of screw etc., and wherein a space is made only in a circumferential area of the middle part of the implant, enabling blood and cells to intrude into the space easily.
  • implants 2 shown in FIGS. 2 to 4 are of screw type; however, the configuration of the implant tooth is not limited to them.
  • the implant tooth of screw type is supported and fixed with the whole ridge, and after treatment, it preferably distributes the chewing force over the whole ridge to convey efficiency into bone.
  • pitch for thread is usually about 0.1 to 2.0 mm.
  • FIG. 3 is a schematic perspective view illustrating another embodiment of the implant composite in accordance with the present invention.
  • the implant composite as shown in FIG. 3 has a configuration similar with the above implant composite, and cells 3 for promoting bone-formation such as mesenchymal stem cells, bone marrow cells or osteoblast cells are introduced into the tube 1 or into the pillar each made of hydroxyapatite ceramics, and are adhered there.
  • porous article of hydroxyapatite ceramics allows a lot of cells to intrude into it as described above, introducing cells 3 for promoting bone-formation into the tube 1 or the pillar around the implant 2 forms bone swiftly, increases the strength of the bone, and also promotes synostosis between the implant and its fixing member.
  • typical examples of the cell 3 for promoting bone-formation include mesenchymal stem cells, bone marrow cells, osteoblast cells, and so on, particularly preferable cells are mesenchymal stem cells or osteoblast cells.
  • various factors such as bone formation factor, angiogenesis growth factor, Enamel Matrix Derivative (EMDOGAIN(R)), etc., or active material such as cytokine, etc., may be soaked into the fixing member for the implant.
  • EMDOGAIN(R) Enamel Matrix Derivative
  • active material such as cytokine, etc.
  • introducing Platelet Rich Plasma (PRP) into the fixing member for the implant may be preferable because PRP will be able to promote breeding of bone cells and curing of gingiva still more.
  • PRP Platelet Rich Plasma
  • introducing artificial blood vessel into the fixing member for the implant enables to further raise the effect of promoting bone-formation.
  • FIG. 4 is a schematic perspective view illustrating still another embodiment of the implant composite in accordance with the present invention.
  • the implant composite shown in FIG. 4 comprises an umbrella 4 consisting of hydroxyapatite ceramics formed adjacent a head portion of the implant 2.
  • the configuration of the umbrella 4 may be appropriate as a conception of pileus for lamps rather than a conception of an umbrella for rain, and it may be inverted-plate, hemispheric, etc.
  • a bottom plane of the umbrella 4 is formed evenly. Outside diameter of the umbrella 4 is about 3 to 20 mm.
  • the above implant composites are effective particularly when the longer implant is inserted at the position where the height of the bone is not enough.
  • the umbrella 4 made of the hydroxyapatite ceramics may be completely inserted into the bone after whittling the bone shallow widely, or may be planted with the situation of being placed on the alveolar bone.
  • the umbrella 4 consists essentially of the foregoing porous article of the hydroxyapatite ceramics.
  • the upper part of umbrella 4 exposing in oral cavity might be preferably made of the foregoing compact article with few pores to prevent invasion of saprophyte.
  • silver ions having bactericidal action may be contained into the umbrella 4.
  • the umbrella 4 may be applied in combination with the foregoing tube.
  • an implant whose at least one part of the periphery is integrated with a hydroxyapatite ceramics into an implant insertion site of an alveolar bone or a gnathic bone may be employed.
  • GBR Guided Bone Regeneration
  • an area where the bone formation is desired might be covered with GBR membrane simultaneously with inserting the implant for the purpose of suppressing breeding of gingiva towards bone side.
  • the porous article of the hydroxyapatite ceramics should be disposed around the implant exposed without being completely covered by the GBR membrane.
  • the exposed surface of the porous article of the hydroxyapatite ceramics may be formed of the foregoing ceramics compact article from a viewpoint of preventing invasion of saprophyte. Moreover, the porous article of the hydroxyapatite ceramics may be disposed inside of the GBR membrane. As thus described, a joint usage of the hydroxyapatite ceramics with the GBR procedure enables to further promote regeneration of bone.
  • a cross-sectional area of the fixing member for the implant is from 1.5 times to 50 times as large as a cross-sectional area of the implant.
  • the cross-sectional area of the fixing member for the implant is smaller than 1.5 times as large as a cross-sectional area of the implant, the effect of using the fixing member for the implant is unable to be achieved.
  • the cross-sectional area of the fixing member for the implant is from 5 times to 36 times as large as the cross-sectional area of the implant.
  • the implant treatment should be carried out effectively because a compensation or a reproduction and so on of the alveolar bone or the gnathic bone can be promoted, the bone tissue is strengthened, and the strength of the bone tissue can be increased swiftly to a degree of stably supporting the implant tooth.
  • the fixing member for the implant or the implant composite each in accordance with the present invention induces to form own bone approximately 100 % among the pores of the fixing member for the implant and accordingly enables to use the inserted implant semi permanently without decaying the alveolar bone or the gnathic bone adjacent the treated site again after the treatment.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Epidemiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Dentistry (AREA)
  • Engineering & Computer Science (AREA)
  • Chemical & Material Sciences (AREA)
  • Ceramic Engineering (AREA)
  • Biomedical Technology (AREA)
  • Developmental Biology & Embryology (AREA)
  • Inorganic Chemistry (AREA)
  • Dermatology (AREA)
  • Medicinal Chemistry (AREA)
  • Transplantation (AREA)
  • Dental Prosthetics (AREA)
  • Prostheses (AREA)
  • Materials For Medical Uses (AREA)
  • Dental Preparations (AREA)
  • Micro-Organisms Or Cultivation Processes Thereof (AREA)
EP04019612A 2003-08-21 2004-08-18 Fixing member for an implant and implant composite Expired - Lifetime EP1508311B1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
JP2003297029 2003-08-21
JP2003297029A JP4215595B2 (ja) 2003-08-21 2003-08-21 インプラント固定部材およびインプラント複合材

Publications (3)

Publication Number Publication Date
EP1508311A2 EP1508311A2 (en) 2005-02-23
EP1508311A3 EP1508311A3 (en) 2005-12-21
EP1508311B1 true EP1508311B1 (en) 2012-12-12

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EP04019612A Expired - Lifetime EP1508311B1 (en) 2003-08-21 2004-08-18 Fixing member for an implant and implant composite

Country Status (5)

Country Link
US (1) US7699612B2 (ja)
EP (1) EP1508311B1 (ja)
JP (1) JP4215595B2 (ja)
KR (1) KR101121146B1 (ja)
CN (1) CN100594011C (ja)

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CN1582864A (zh) 2005-02-23
JP2005065803A (ja) 2005-03-17
US20050079469A1 (en) 2005-04-14
KR101121146B1 (ko) 2012-03-19
KR20050020938A (ko) 2005-03-04
JP4215595B2 (ja) 2009-01-28
EP1508311A3 (en) 2005-12-21
US7699612B2 (en) 2010-04-20
EP1508311A2 (en) 2005-02-23
CN100594011C (zh) 2010-03-17

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